Integrated, Extendable Anesthesia System

ABSTRACT

The specification describes anesthesia systems with an integrated, extendable clinical center and clinician/anesthesia office that accommodates for physical separation of clinical and clerical functions. The disclosed anesthesia systems allow for a portion of the system to be brought closer to the patient such that clinical controls can be accessed while tending to the patient airway, without compromising office space available to the clinician or crowding the patient area.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application relies on U.S. Provisional Patent ApplicationNo. 61/252,269, entitled “Integrated Anesthesia System”, and filed onOct. 16, 2009, and is hereby incorporated by reference in its entirety.

FIELD OF THE INVENTION

The present invention relates to medical systems. More particularly, thepresent invention relates to an anesthesia system, having an integrated,extendable clinical center and clinician/anesthesia office.

BACKGROUND OF THE INVENTION

Anesthesiologists spend many hours in relatively straight-forward casesrequiring their vigilance, but little direct clinical action. They areoften required to perform various paperwork and documentation activitieswith only an anesthesia system's tabletop as a work surface. Further,there are typically no storage areas for their documents, files, andpersonal items, such as cell phones, keys, computers, glasses, wallets,purses, etc. Still further, the clinical usage area of a conventionalanesthesia system provides no convenient location for syringes,laryngoscopes and other clinical equipment. Conventional designs ofanesthesia systems do not accommodate separation of clinical andclerical functions. Most systems provide only modest amounts of spacefor the anesthesiologist to conduct their work and that must be sharedwith space used for clinical setup of drugs and instruments.

Further, most current anesthesia system designs provide no articulationof the breathing circuit connections in order to provide a closerpneumatic and sensor link to a patient. Since most current breathingsystem designs are completely integrated into the anesthesia system, theentire system must be brought in close proximity to the patient in orderto have access to the necessary clinical controls while attending to thepatient and their airway. This physical architecture drives the need forvery small footprint systems, which further limit the space availablefor the anesthesiologist to work on.

While some conventional prior art anesthesia systems allow for thebreathing circuit to be articulated away from the system and be placedin close proximity to the patient, these systems still have most oftheir clinical controls located on the main body of the system, thusmaking use quite cumbersome.

For example, a typical, conventional anesthesia system employs abreathing circuit on a double-hinged tubular arm that can be moved awayfrom the anesthesia system trolley. This requires draping of the hosesfrom the breathing system to the trolley, including fresh gas hoses,ventilator drive gas and scavenging gas—all with the possibility ofleakage and disconnection. Further, the ventilation, FGF and vaporizercontrols on this system are located back on the trolley and away fromthe user's direct clinical interaction with the patient. This isdisadvantageous in that the user constantly needs to turn away from thepatient to observe monitoring or make adjustments. Also, the tubular armis prone to damage by excessive applied forces from beds, people etc.when in the extended position.

Some newer conventional anesthesia systems have fixed the breathingcircuit and the controls on the trolley frame, requiring the user tobring the entire system closer to the patient. This has forced areduction in system size, thereby reducing the “workspace” available tothe anesthesiologists. In addition, the anesthesiologist's work area fordocumentation and storage is also brought proximate to the patient andthe clinical field which is undesirable from a clinical and spacemanagement standpoint. In the alternative, a user can position thesystem further away from the patient, but then must constantly turn backand forth from the patient to observe the monitoring and make settingchanges.

Hence, currently available anesthesia systems do not provide thenecessary storage area, types, or connectivity required by a modern dayanesthesiologist. These include power attachments and storage forpersonal electronic products such as computers, PDAs, data/mobile phonedevices, personal music devices, wireless headsets etc. Considering thatmany anesthesiologists do not have offices within the hospitals in whichthey work, there is a need to satisfy the user of the anesthesia systemwith enhanced provisions for conducting their daily activities,including case documentation. Some of the features required such as tapedispensers, lined garbage bins and documentation storage areas, etc.,are commonly found in office environments, but nevertheless have notbeen integrated onto currently available anesthesia systems.

What is therefore needed is an anesthesia system which accommodatesseparation of clinical and clerical functions. What is also needed is ananesthesia system that allows for a portion of the system to be broughtcloser to the patient such that clinical controls can be accessed whiletending to the patient airway, without compromising office spaceavailable to the clinician or crowding the patient area.

In addition, conventional anesthesia systems are equipped with alarmsdesigned to alert a user to potential technical problems occurring withthe system's behavior. These alarms are typically short text stringsthat fit within a limited space for display on a video screen providedon the anesthesia system and thus cannot provide detailed informationdescribing the technical issue causing the alarm. Also, these alarmstrings may be required to be translated into various localizedlanguages that may not reflect the error as unambiguously as thedesigners may have envisioned in the English language. Some prior artproduct designs include posting of additional descriptive text orgraphic representations on the video screen describing the potentialproblem being reflected by the alarm. However, these require morefocused attention of the clinical user to read or try to correlate thegraphic to the actual system that they are using. Oftentimes, the alarmsfor anesthesia systems occur during a medical emergency situation,creating a confusing and tense situation for the user. In addition, manyusers are not familiar with the intricate details of the system'sfunction and cannot easily correlate an alarm message to the necessarycorrective actions. Further, many users utilize various manufacturer'ssystems that may use identical or similar alarm messages to definediffering equipment failures, problems or behaviors. Also, the shortenedtext strings and/or translations used for alarm messages do not presentsufficient information to allow the user to adequately diagnose theproblem. Hence, an improved alarm display system is required.

Some conventional anesthesia machines are currently fitted with “AlarmSilence” buttons that can be pressed to silence the audible portion ofthe system's alarms for periods of up to two minutes. This functionensures that the alarm is specifically acknowledged and directlysilenced by the user. However, requiring that the alarm silence buttonbe physically pressed can be frustrating to users who have their handsoccupied with the care of the patient (e.g. suctioning, re-intubating,administering drugs). Consequently, what is needed is a method forsilencing the alarms in a non-contact, yet still reliable manner. Thisis especially true when the user is being barraged by a series of alarmsall related to a single event or clinical condition. For example, alarmsthat sound during suction of a patient, low pressure alarms, leakagealarms, low Minute Volume alarms, and low Tidal Volume alarms may all beactivated at different times.

Further, most conventional anesthesia systems have a function referredto as “O₂ Flush”. The flush is used principally for refilling thebellows in the presence or upon correction of a leak and for flushinganesthetic agent out of a circle system. Upon activation of the O₂ flushfor the purposes of refilling the bellows, the bellows fills up with gasthat does not contain anesthetic agent. Consequently, theanesthesiologist is required to rebalance the amount of anesthetic agentpresent in the circuit in order to ensure correct treatment of thepatient. Hence, it is desirable to have a single action function inorder to provide a high flow similar to that of the O₂ flush, whileemploying levels of mixed gas and anesthetic agent that have been userpredefined, in order to enable the bellows to be refilled whilepreserving the previously set gas mixtures and anesthetic agent levels.

Precise monitoring of the volumes and pressures delivered to ventilatedpatients is extremely important, especially when presented withpulmonary complications. Measuring these flows and pressures at thepatient's airway provides substantial advantages as compared tomeasuring these parameters inside the anesthesia machine. Currentproximal sensors utilize pneumatic or electrical connections back to theAnesthesia system. This connection creates significant bulk and weightat the patient's airway that can lead to disconnections and physicalpulling on the patient's endotracheal tube. Consequently, many usersperceive this to be a significant disadvantage of proximal sensors andchoose to perform patient monitoring and delivery control at a lessdesirable location closer to the anesthesia system. Further, the use ofdifferential pressure type flow sensors and proximal airway pressuresensors require the use of pneumatic tubes to be attached to theanesthesia system. These tubes can be kinked or occluded by wheels ofequipment being moved in the OR, causing data loss on the sensorchannel. Pneumatic tubes can also be a source of gas leakage from thebreathing circuit and their length can result in flow measurement errorsdue to pneumatic signal transit, common mode errors. Hence, a single,small sensor solution for proximal placement without tubes orconnections back to the anesthesia system is therefore needed.

Contemporary anesthetic vaporizer systems contain valves and/or wicksystems for transitioning liquid anesthetic agent into a gaseous form.Typically, these systems provide an agent concentration level of 0-10%(although sometimes higher for Suprane) of the gas being used as “freshgas” or “make up” gas in a circle breathing system. Contemporary devicesare rather complex and require precision mechanical components or flowcontrol systems to operate, creating a relatively high cost device. U.S.Pat. No. 6,155,255 (the '255 patent), herein incorporated by referencein its entirety, proposes a method for generation and control ofanesthetic vapor in a flow stream. The '255 patent describes injectionof liquid agent into a porous “evaporator” media, through whichbreathable gas is flowing. However, the '255 patent is disadvantageousin that it does not adequately describe additional elements that wouldbe necessary in order to utilize the patent in a practical manner. Inparticular, it is desirable to know the amount of gas flow being movedthrough the evaporator and have direct means for determining theconcentration of anesthetic in the breathable gases that is beingproduced. It is also desirable to precisely measure the amount of liquidflow into the evaporator for the purposes of computing agentconcentrations, etc. Hence, means of incorporating a known vaporizersystem into an anesthesia system are required.

SUMMARY OF THE INVENTION

In one embodiment, the present invention is an anesthesia system, havingan integrated, extendable clinical center and clinician/anesthesiaoffice that accommodates for physical separation of clinical andclerical functions. In another embodiment, the present invention is ananesthesia system that allows for a portion of the system to be broughtcloser to the patient such that clinical controls can be accessed whiletending to the patient airway, without compromising office spaceavailable to the clinician or crowding the patient area.

In one embodiment, the present invention is an anesthesia deliverysystem, comprising a first section comprising support for at least oneclinical control and at least one patient connection for providingtherapy to a patient, wherein said at least one patient connectionincludes a breathing circuit connection, comprising at least one limb,wherein the at least one limb may be inspiratory, expiratory or acombination thereof and a second section, comprising a base portion forsupporting and housing the first section and further comprising supportsfor pneumatic and electrical connections and wherein the first sectionis extendable relative to the second section, exposing at least oneworkspace when extended, and wherein the second section is pneumaticallyconnected to the first section via a suction supply and at least oneanesthesia gas supply.

In one embodiment, the first section of the present invention furthercomprises a clinical center section which includes at least one of: aventilator display; a physiological monitor; a physiologic monitordisplay; respiratory gas analysis and connections; Patient SuctionControls; Auxiliary Oxygen Controls and Connections; Fresh Gas FlowMixing and Controls; Vaporizers and Attachment Back Bar; Syringe PumpMounts; Expandable Clinical Workspace; and Wireless Sensor Docking.

In one embodiment, the second section of the present invention furthercomprises an anesthesia office section which includes at least one of:space for an anesthesiologist's documentation, storage and personaleffects; work surfaces to support both the standing and sitting behaviorof the anesthesiologist; pull-out trays that allow for a computerkeyboard; personal electrical equipment connectors on the front of theanesthesia office section; foot rest with angled front to allow kneeroom; and lighting of work areas for operation in low light conditions.

In one embodiment of the present invention, the second section furthercomprises a base portion which includes a sliding track upon which firstsection is rotatably extendable from a fully integrated position into afirst extended position relative to the second section.

In one embodiment, the first section is rotatably extendable from thesecond section at an angle ranging from 0 degrees to 45 degrees andoptionally, rotatably extendable in angular increments.

In another embodiment of the anesthesia delivery system of the presentinvention, the first section is linearly extendable from the secondsection, in a range of 0 to 14.5 inches, into a second extended positionrelative to the second section.

In yet another embodiment of the anesthesia delivery system of thepresent invention, the first section is, from a fully integratedposition, both rotatably and linearly extended away from the secondsection such that it is in a third and fully extended position. In oneembodiment, the anesthesia delivery system of the present inventionfurther comprises at least one floor contact point providingload-bearing support. In one embodiment, the at least one floor contactpoint is a rotating trackball. In another embodiment, the at least onefloor contact point is a rotating caster wheel having multiple rollersfor both inline and side to side movement. In yet another embodiment,the at least one floor contact point is configured with appropriategeometry to move obstructions on the floor as the first section isextended away from the second section. In one embodiment, of theanesthesia delivery system of the present invention, a user-initiatedactuation results in a motorized movement of the first section relativeto the second section. In another embodiment, the motorized movement ofthe first section is automatically stopped if an obstruction to themovement is detected. In one embodiment, the obstruction is detected bydetecting a change in electric current drawn by a movement motorcontained within the system. In yet another embodiment, an audio,visual, or audio-visual alarm is provided if an obstruction to themovement is detected.

In an optional embodiment of the anesthesia delivery system of thepresent invention, the patient is connected to the system via acircle-less breathing circuit which comprises an inspiratory and anexpiratory valve, wherein fresh gas is injected through the inspiratoryvalve, mixed with an injected agent, delivered to a patient and then ledout via the expiratory valve and wherein the inspiratory valve furthercomprises a plurality of control valves to blend at least two of oxygen,air and nitrous oxide directly into the breathing circuit.

In one embodiment, the anesthesia system of the present inventionfurther comprises an information projection lighting system forindicating the status of a control of the system by directlyilluminating the controlled function.

In one embodiment, the present invention is an anesthesia deliverysystem, comprising: a first section comprising support for at least oneclinical control and at least one patient connection for providingtherapy to a patient, wherein said at least one patient connectionincludes a breathing circuit connection, comprising at least one limb,wherein the at least one limb may be inspiratory, expiratory or acombination thereof; a second section, comprising a base portion forsupporting and housing the first section and further comprising supportsfor pneumatic and electrical connections, wherein the first section islinearly and rotatably extendable relative to the second section, andwherein the second section is pneumatically connected to the firstsection via a suction supply and at least one anesthesia gas supply; andan information projection lighting system for indicating the status ofat least one function of the system by direct illumination.

In one embodiment, the information projection lighting system furthercomprises adjustable lighting, wherein the lighting can be adjusted bycolor, intensity or flash rate.

In another embodiment, the information projection lighting system of thepresent invention indicates an anomalous operational condition of theanesthesia system by direct illumination of the portion of theanesthesia delivery apparatus suspected of causing the anomalousoperating condition.

In another embodiment, the information projection lighting systemindicates when a ventilator within the anesthesia system is in an activestate by illuminating a bellows of the ventilator.

In yet another embodiment, the information projection lighting systemindicates when a ventilator within the anesthesia system is in aninactive state by illuminating an APL valve of the ventilator.

In yet another embodiment, the information projection lighting systemindicates when a ventilator within the anesthesia system is in aninactive state by illuminating a pressure gauge of the ventilator.

In yet another embodiment, the information projection lighting systemindicates when a ventilator within the anesthesia system is in aninactive state by illuminating a bag arm of the ventilator.

In yet another embodiment, the information projection lighting systemilluminates a Common Gas Outlet Port of the anesthesia system whencontrols are set to have gas emerge from the Common Gas Outlet Port.

In yet another embodiment, the information projection lighting systemilluminates an auxiliary flow tube if auxiliary flow has been turned on.

In yet another embodiment, the information projection lighting systemilluminates a CO₂ absorbent canister if the canister is disengaged fromthe breathing circuit and/or if there is an alarm for high CO₂ in therespiratory gas.

In yet another embodiment, the information projection lighting systemilluminates a side stream respiratory gas monitor water trap if therespiratory gas monitor is alarming to indicate an obstruction.

In another embodiment, the present invention is directed toward ananesthesia delivery system, comprising a first section comprisinghousing for at least one clinical control and at least one patientconnection for providing therapy to a patient, wherein said at least onepatient connection includes a breathing circuit connection, comprisingat least one limb, wherein the at least one limb may be inspiratory orexpiratory or a combination thereof; and a second section, comprising abase portion for supporting the first section, a planar workspacesurface, at least one pneumatic connection and at least one electricalconnection, wherein the second section is pneumatically connected to thefirst section by a suction supply line and at least one anesthesia gassupply line and wherein the first section is movable relative to thesecond section. The planar workspace surface should be of sufficientlength and width (or depth) to enable an anesthesiologist to comfortablytake notes, such a space can be, but is not limited to 3 in×3 in, 8.5 in×11 in, 11 in×14 in or any dimensional increment therein (3 inches to 11inches or 3 inches to 14 inches).

Optionally, the second section comprises an area for housing at leastone of: a storage space, a first work surface at first elevation, asecond work surface at a second elevation, wherein the first elevationis higher than the second elevation; at least one pull-out tray; atleast one electrical equipment connector wherein said connectorinterface extends outward toward the front of said second section; anangled planar surface at said base of the second section adapted tofunction as a foot rest; and lighting. The first work surface at a firstelevation is preferably a planar workspace surface of sufficient lengthand width (or depth) to enable an anesthesiologist to comfortably takenotes, such a space can be, but is not limited to 3 in×3 in, 8.5 in ×11in, 11 in×14 in or any dimensional increment therein (3 inches to 11inches or 3 inches to 14 inches), which is of a sufficient elevation toallow an average size person to stand and write on surface. The firstelevation can be two feet or higher. The second work surface at a secondelevation is preferably a planar workspace surface of sufficient lengthand width (or depth) to enable an anesthesiologist to comfortably takenotes, such a space can be, but is not limited to 3 in×3 in, 8.5 in ×11in, 11 in×14 in or any dimensional increment therein (3 inches to 11inches or 3 inches to 14 inches), which is of a sufficient elevation toallow an average size person to sit and write on surface. The firstelevation can be three feet or lower.

Optionally, the base portion of the second section comprises a slidingtrack upon which first section is rotatably extendable from a firstposition to a second position. In the first position, the second sectionand the first section are integrated into each other. It should beappreciated that the second and first section may integrate or beotherwise pulled into each other by having the second section embeditself into the first section, the first section embed itself into thesecond section, having the external housings of both the first andsection sections meet to thereby prevent any access into the internalworkspace areas of the second section, or otherwise close. In the secondposition, the first section extends away from said second section andprovides physical access to the planar workspace surface.

Optionally, the first section is rotatably extendable from the secondsection at an angle ranging from 0 degrees to 45 degrees. The firstsection is rotatably extendable in angular increments. The first sectionis configured to linearly extend from the second section in order tomove from a first position to a second position, as described above. Thefirst section is linearly extendable from the second section at adistance ranging from 0 to 14.5 inches.

Optionally, the first section is, from a fully integrated position, bothrotatably and linearly extended away from the second section such thatit is in an extended position. Optionally, the delivery system comprisesat least one floor contact point providing load-bearing support.Optionally, the at least one floor contact point is a rotatingtrackball. Optionally, the at least one floor contact point is arotating caster wheel having multiple rollers for both inline and sideto side movement. Optionally, a user-initiated actuation results in amotorized movement of the first section relative to the second section.Optionally, the motorized movement of the first section is automaticallystopped if an obstruction to the movement is detected by a controller,wherein said controller is configured to detect a change in electriccurrent drawn by a movement motor causing said motorized movement.Optionally, an audio, visual, or audio-visual alarm is provided if anobstruction to the movement is detected. Optionally, the patient isconnected to the system via a circle-less breathing circuit whichcomprises an inspiratory and an expiratory valve, wherein fresh gas isinjected through the inspiratory valve, mixed with an injected agent,delivered to a patient and then led out via the expiratory valve andwherein the inspiratory valve further comprises a plurality of controlvalves to blend at least two of oxygen, air, or nitrous oxide directlyinto the breathing circuit. Optionally, the system further comprises alighting system for indicating the status of a control of the system bydirectly illuminating the controlled function. In one embodiment, thelighting system only illuminates a control who status has changed, is inan alert condition, or which otherwise requires the attention of thephysician while not illuminating any other control.

Optionally, the second section and first section are only in physicalcommunication with each other at the point of the structures responsiblefor enabling the rotating or linear movement. Optionally, the secondsection and first section are not physically connected at any otherpoint except where the second section supports the first section for thepurpose of enabling the rotating or linear movement.

In another embodiment, the anesthesia delivery system comprises a firstsection comprising support for at least one clinical control and atleast one patient connection for providing therapy to a patient, whereinsaid at least one patient connection includes a breathing circuitconnection, comprising at least one limb, wherein the at least one limbmay be inspiratory, expiratory or a combination thereof; a secondsection, comprising a base portion for supporting and housing the firstsection and at least one pneumatic or electrical connection, wherein thefirst section is linearly, rotatably or linearly and rotatablyextendable relative to the second section, and wherein the secondsection is pneumatically connected to the first section via a suctionsupply line or an anesthesia gas supply line; and a lighting system forindicating the status of at least one function of the system by directillumination.

The aforementioned and other embodiments of the present shall bedescribed in greater depth in the drawings and detailed descriptionprovided below.

BRIEF DESCRIPTION OF THE DRAWINGS

These and other features and advantages of the present invention will befurther appreciated, as they become better understood by reference tothe detailed description when considered in connection with theaccompanying drawings, wherein:

FIG. 1A is an overview illustration of the anesthesia system of thepresent invention, with cut-away diagrams of the Clinical Center and theAnesthesia Office sections;

FIG. 1B is a system flow diagram of the anesthesia system of the presentinvention;

FIG. 1C is a backside illustration of the anesthesia system of thepresent invention;

FIG. 1D is a cut-away portion of the anesthesia system of the presentinvention showing the ventilation monitoring connection, a sampleinterface for a respiratory gas monitor, and the anesthesia gasscavenging system;

FIG. 2A is an illustration of the anesthesia system of the presentinvention in a first configuration, fully rotated and telescoped;

FIG. 2B depicts the anesthesia system of the present invention in asecond configuration, fully telescoped, but not rotated;

FIG. 2C depicts the movement of anesthesia system of the presentinvention in a third configuration, as the CC is compressed andcollapsed back into the AO and thus in a partially telescoped position;

FIG. 2D depicts the movement of anesthesia system of the presentinvention in a fourth configuration, as the CC is compressed andcollapsed back into the AO and thus in a fully collapsed position;

FIG. 2E depicts the incremental angular motion of the CC as it ispartially rotated away from the AO, in a fifth configuration;

FIG. 2F depicts the incremental angular motion of the CC as it is fullyrotated away from the AO, in a sixth configuration;

FIG. 3A is an illustration of a clinician standing at the anesthesiasystem of the present invention;

FIG. 3B is an illustration of a clinician standing at the anesthesiasystem of the present invention, using an upper pull-out shelf as adesk;

FIG. 3C is an illustration of a clinician sitting at the anesthesiasystem of the present invention;

FIG. 4A is a schematic drawing of a side door storage integrated withthe anesthesia system of the present invention;

FIG. 4B is an illustration of an open side door storage area of theanesthesia system of the present invention;

FIG. 4C is an illustration of a closed side door storage area of theanesthesia system of the present invention;

FIG. 5A is a schematic drawing of an upper and lower pull out shelfintegrated with the anesthesia office portion of the anesthesia systemof the present invention;

FIG. 5B is an illustration of a lower pull out shelf integrated with theanesthesia office portion of the anesthesia system of the presentinvention, in an open position;

FIG. 5C is an illustration of a lower pull out shelf integrated with theanesthesia office portion of the anesthesia system of the presentinvention, in a stowed position;

FIG. 5D is an illustration of an upper pull out shelf integrated withthe anesthesia office portion of the anesthesia system of the presentinvention, in an open position;

FIG. 5E is an illustration of an upper pull out shelf integrated withthe anesthesia office portion of the anesthesia system of the presentinvention, in a stowed position;

FIG. 6A is a schematic drawing of storage and electrical connectionareas integrated with the anesthesia office portion of the anesthesiasystem of the present invention;

FIG. 6B is an illustration of a storage area integrated with theanesthesia office portion of the anesthesia system of the presentinvention;

FIG. 6C is an illustration of a electrical connection area integratedwith the anesthesia office portion of the anesthesia system of thepresent invention;

FIG. 7A is a schematic drawing of a handle activated castor lockprovided in the AO in accordance with an embodiment of the invention;

FIG. 7B is an illustration of a handle activated castor lock provided inthe AO in accordance with an embodiment of the invention;

FIG. 8 is an expanded view of a tape dispenser area and physiologicmonitor connections provided in the clinical center of the anesthesiasystem of the present invention;

FIG. 9A is a schematic drawing of the system status computer providedwith the anesthesia system of the present invention;

FIG. 9B is an illustration of the information projection lightingfeature of the anesthesia system of the present invention;

FIG. 9C is an illustration of the wireless sensor and sensor dockingfeature of the anesthesia system of the present invention;

FIG. 10A is an illustration of the CGO gas port provided in theanesthesia system of the present invention, in a horizontal and activeposition;

FIG. 10B is an illustration of the CGO gas port provided in theanesthesia system of the present invention, in a vertical and inactiveposition;

FIG. 11A is a diagram showing some basic elements of a conventionalcircle breathing circuit indicating which major elements have beeneliminated, or are not required, in the circle-less breathing circuit ofthe anesthesia system of the present invention;

FIG. 11B illustrates a circle-less breathing circuit, in accordance withan embodiment of the anesthesia system of the present invention; and

FIG. 11C illustrates an optimally shaped anesthetic gas pulse so that apulse train of anesthetic gas may be injected in real-time into theinspiratory flow stream of a patient.

DETAILED DESCRIPTION OF THE INVENTION

The present invention is directed towards an anesthesia system, havingan integrated, extendable clinical center and clinician/anesthesiaoffice. The present invention is directed towards an anesthesia systemwhich accommodates for physical separation of clinical and clericalfunctions. The present invention is also directed towards an anesthesiasystem that allows for a portion of the system to be brought closer tothe patient such that clinical controls can be accessed while tending tothe patient airway, without compromising office space available to theclinician or crowding the patient area.

The present invention is directed towards multiple embodiments. Thefollowing disclosure is provided in order to enable a person havingordinary skill in the art to practice the invention. Language used inthis specification should not be interpreted as a general disavowal ofany one specific embodiment or used to limit the claims beyond themeaning of the terms used therein. The general principles defined hereinmay be applied to other embodiments and applications without departingfrom the spirit and scope of the invention. Also, the terminology andphraseology used is for the purpose of describing exemplary embodimentsand should not be considered limiting. Thus, the present invention is tobe accorded the widest scope encompassing numerous alternatives,modifications and equivalents consistent with the principles andfeatures disclosed. For purpose of clarity, details relating totechnical material that is known in the technical fields related to theinvention have not been described in detail so as not to unnecessarilyobscure the present invention.

FIG. 1A and FIG. 1B illustrates one embodiment of the anesthesia system100 of the present invention, which allows for proper workflowmanagement of the anesthesiologist's work area. The anesthesia system100 of the present invention is a small, compact system configuration,and can be easily moved in close proximity to a patient's bedside. Inone embodiment, the present invention provides an anesthesia system thatcomprises a first section 102 and a second section 104, where the firstsection 102 includes support for at least one clinical control and atleast one patient connection for providing therapy to a patient. In oneembodiment, the patient connection includes a breathing circuit. In oneembodiment, the second section 104 comprises a base portion forsupporting and receiving the first section 102. In addition, the secondsection 104 comprises pneumatic and electrical connections. In oneembodiment, the second section 104 is pneumatically connected to thefirst section 102 via a suction supply and at least one anesthesia gassupply. In one embodiment, first section 102 is extendable relative tothe second section 104 and is capable of moving on a sliding track outfrom the base provided on the second section 104. In one embodiment, thetrack is positioned at an oblique angle, to the front face and base ofthe second section, allowing the movement of the first section to moveforward and left from the second section.

In one embodiment, the first section 102 comprises a Clinical Center(CC) section and the second section 104 comprises an Anesthesia Office(AO) section.

Clinical Center (CC) and Clinician/Anesthesia Office (AO)

In one embodiment, “Clinical Center” (CC) section 102 of the anesthesiasystem 100 illustrated in FIG. 1A comprises at least one clinicalcontrol and at least one patient connection for providing therapy to apatient.

As shown in the upper level system architecture of FIG. 1B, theanesthesia system 100 comprises both pneumatic and electricalconnections. Referring now to FIG. 1B, the clinical center (CC) 102 is,in operation, pneumatically connected to the patient via at least onebreathing circuit connection. In one embodiment, the breathing circuitcomprises at least one or both of an inspiratory limb and expiratorylimb. The terms “inspiratory limb” and “expiratory limb” are standardcomponents of most ventilation and anesthesia systems and are thus wellknown in the art and not further defined herein. In one embodiment, theinspiratory and expiratory portions of the circuit are coaxial andhoused in one limb.

Further, the functional system architecture of the CC 102 utilizes aplurality of connections such as regulated supply pressure (e.g. 30 PSI)for O₂, N₂O and air, wall suction, electrical power, and datacommunications (e.g. internal system or hospital network) from the AO104.

In one embodiment, CC 102 includes a pneumatic connection forrespiratory gas that is fed into the system of the present invention viaa sample line. CC 102 also includes a pneumatic auxiliary oxygenconnection that is directed away from CC 102. In addition, CC 102includes a pneumatic suction connection to the anesthesia office 104 ofthe present invention. In one embodiment, CC 102 is electricallyconnected to physiologic monitoring equipment.

Referring to FIGS. 1A, 1B, 1C, and 1D, CC 102 functionalities andcomponents include a ventilator (not shown) housed in a cabinet 118;ventilator monitoring parameter connections 119; a ventilator display109; a physiological monitor 132 (shown in FIG. 1C); at least onephysiologic monitor display 111; respiratory gas analysis andconnections 163 from FIG. 1D; breathing circuit (circle or circle-less)and controls 150; common gas outlet (also referred to as AuxiliaryCommon Gas Outlet) 151; APL Valve 152, Bag 153, and Pressure Gauge 154;Bag to Vent Switch 106; Bellows 107; CO₂ Absorber 155; Anesthetic GasScavenging 156; Patient Suction Controls 157 and Catheter Storage 158;Auxiliary Oxygen Controls (also referred to as auxiliary Flow Tube) 112and Connections 113; Fresh Gas Flow Mixing 160 and Controls 161;Vaporizers and Attachment Back Bar 108; Syringe Pump Mounts 116;Expandable Clinical Workspace 115; and Wireless Sensor Docking 117.

Referring back to both FIG. 1A and FIG. 1B, the anesthesia office (AO)104 is pneumatically connected to CC 102 via a suction supply andanesthesia gas supplies (integrated into the system structure), whichinclude regulated O₂, N₂O, and air. AO 104 is also pneumaticallyconnected to a wall suction unit, an air pipeline, an O₂ pipeline, andan N₂O pipeline. AO 104 is electrically connected to an accessory powersource, AC power, and external communication means.

Anesthesia office 104 functionalities and components include userstorage areas 120; computer connections and network connections area125; cylinder attachments (not shown, located behind system), checkvalves (not shown, integrated into system) and regulation support (notshown, integrated into system); pipeline attachment (not shown, locatedbehind system), check valves (not shown, integrated into system), andregulation (not shown, integrated into system); suction attachment (notshown, located behind system); automatic N₂O shut-off with no O₂ (notshown, integrated into system); AC to DC power regulation (not shown,integrated); AC power isolation to accessory connections (not shown,integrated); back-up electrical power systems (not shown, integrated);and a mounting area for 3^(rd) party monitoring 170.

In one embodiment, the AO 104 includes a support base for the anesthesiasystem 100 of the present invention, providing a usable space 171 forthe anesthesiologist's documentation, storage 172 and personal effects173. The AO 104 is equipped with features such as work surfaces 174, 175to support both the standing and sitting behavior of theanesthesiologist (as shown in FIGS. 3A, 3B, and 3C), pull-out trays 176that allow for a computer keyboard, medical tape dispenser, personalelectrical equipment connectors 178 on the front of the AO, side doorstorage 177, which, when opened contains easy to clean pockets andcubbies for storage of office items like pens, notes, clipboards, files,etc., foot rest with angled front to allow knee room 179, a handle basedcaster unlock feature 180 and lighting 181 of work areas for operationin low light conditions.

In one embodiment, the AO 104 houses all pneumatic supplies, ACelectrical support and data communication connections for the anesthesiasystem, and supplies the CC 102 with the necessary inputs for itsfunction. In one embodiment, the AO may be considered the “hub” of theanesthesia system 100 and provides the functions of: AC to DC powerconversion for the anesthesia system components including the CC, ACpower isolation for accessory outlets, backup power supply (i.e.battery, UPS), pneumatic protection of pipeline sources (i.e. filters,check valves), cylinder attachment and mounting locations, primaryregulation of cylinder supplies with automatic pipeline loss cross-over,a system status screen, and hospital network data connections.

FIG. 1C illustrates the backside of one embodiment of the anesthesiasystem of the present invention, showing a connections area 130, whereelectrical connections are made to monitoring equipment. Further, asdescribed earlier above, FIG. 1C also shows physiological monitor 132.

FIG. 1D illustrates ventilation monitoring parameter connections area119 in greater detail. Further, FIG. 1D also shows anesthesia gasscavenging system 156 in enlarged detail. And finally, the figure alsoshows a sample attachment interface 163 for a respiratory gas monitor.

Referring back to FIG. 1A, several types of movements are available toposition the CC 102 relative to the AO 104 in the anesthesia system ofthe present invention. First, a rotational movement can be used torotate the breathing circuit 150 (or the CC 102) away from or towards AO104 at junction 197, in incremental angles up to 45 degrees, such thatCC 102 is in a first extended position relative to AO 104.

In one embodiment, the CC 102 is moved on a sliding track (not shown),located on the base support on the AO 104 out from its locked position(i.e. fully integrated position) on the AO 104 into a fully extendedposition. In one embodiment, a portion of the track is preferablypositioned at an oblique angle, which is, in one embodiment 24 degrees,to the front face and wheel base of the AO 104, allowing the movement ofthe CC 102 and its connection ports to move forward and left from itsfully integrated position.

Second, a translational movement at junction 196 having a range of 0 to14.5 inches is available to compress and collapse the CC 102 back intoAO 104 or extend CC 102 away from AO 104. In addition, the translationalmovement at junction 196 also results in translational movement atjunction 197. Thus, once translated away from AO 104, CC 102 is in asecond extended position relative to AO 104.

In addition, the aforementioned rotational and translational movementscan be combined, such that CC 102 is in a third extended positionrelative to AO 104.

It should be evident to those of ordinary skill in the art, thatalthough only a few positions are shown, CC 102 can have a plurality ofpositions relative to the AO 104. In one embodiment, the workspace point(shown as 297 in FIG. 2A and described in greater detail below) can beaccessed by rotating, translating, or both rotating and translating CC102 away from AO 104.

FIG. 2A illustrates the CC 202 telescoped outwards and away from the AO204, creating a clinical workspace area for the clinician's use. By wayof comparison, and referring back to FIG. 1A, the anesthesia system 100of the present invention shown in FIG. 1A is in a fully collapsedposition. Referring back to the telescoped system 200 in FIG. 2A, thegap created as the CC 202 moves away from the AO 204 expands and exposeswork surface 210 such that it extends out from areas under the main AOwork surface 207. These surfaces 210 have close tolerance or flexibleseals at their interfaces 211 to avoid having materials sitting on thesurfaces being jammed into the gap between surfaces. In an embodiment,the movement of the CC 202 is indexed in order to create a rigidpositioning means for the CC 202 relative to the AO 204. In otherembodiments a plurality of other locking means not involving indexingcould also be utilized, in order to obtain a locking mechanism rigidenough to prevent inadvertent movement of the CC 202 relative to the AO204, and the dislodging of articles on the expanded work surface 210.

In yet another embodiment, the CC 202's movement relative to the AO 204is motorized and is actuated electronically by user controls on theanesthesia system 200. In an example, a single user actuation results ina preprogrammed motorized movement of the CC 202 relative to the AO 204.In an embodiment, if the user-actuated motorized movement of the CC 202encounters an obstruction, the movement of the CC 202 is automaticallystopped. In one embodiment the change in electric current drawn by themovement motor is utilized to detect obstruction. At the same time, inadditional or alternative embodiments, obstruction signals in the formof audio alarm and/or visual alarms, such as a flashing light is used toindicate obstruction (to user) and the resulting stalled movement of theCC 202. In one embodiment, existing lights used for illuminating variouselements of the anesthesia system are utilized as alarm flashing lights.Examples of such existing lights comprise those in the overhead areanear point 196 in FIG. 1A focusing on the vaporizers and/or the worksurface that is proximal to point 197 of FIG. 1A.

Further, FIG. 2A illustrates at least one floor contact point 225 at thebottom of the CC 202. As the CC 202 moves a considerable distance awayfrom the AO 204 and the main four wheel trolley base 214, it is notpractical to cantilever the CC 202 part of the system from the AO 204,due to tip and strength concerns. Consequently, the CC 202 employs itsown ground contact point 225 to allow for load-bearing, which mayinclude one or more users leaning on the CC 202, to be transferreddirectly to the floor rather than through the AO 204 trolley frame.

In one embodiment, the at least one contact point 225 is capable ofproviding equal horizontal friction in a full 360 degree pattern and is,but is not limited to, a rotating trackball type or caster wheel type(having multiple rollers) of moveable load transfer mechanism thatenables both inline and side to side movement. The use of a moveablecontact ensures that the CC 202 and the anesthesia system 200 can bemoved or relocated in its entirety and quickly, even in an “open” orfully extended configuration. In an embodiment, the anesthesia system200 is locked using a central brake system that locks either two or fourof the wheels under the AO 204. This central brake system, is, in oneembodiment, controlled via a foot pedal 215, known to those of ordinaryskill in the art, or may be controlled via a hand lever positioned inone or more locations on the anesthesia system's movement handles, whichis described in greater detail below. The hand lever provides a moredirect lock/unlock arrangement.

In one embodiment, the at least one contact point 225 is disengaged fromthe floor when the CC 202 is moved into its base, locking positionagainst the AO 204, leaving just the original, standard four casters incontact with the floor. Alternatively, the contact between the CC 202and the floor could be maintained even in the locked position. In oneembodiment, the contact point 225 is configured with the appropriategeometry to move obstructions on the floor as the contact point 225 isextended, including, but not limited to elements such as a cover orflexible spring that comes in close proximity to the floor and therebypushes or lifts obstructions prior to these obstructions getting closeto the contact points 225 on the floor.

Thus, in various embodiments, the floor contact point and movementmechanisms of the CC allow for load bearing to the workspace areacreated by its movement away from the AO, with no risk of tipping ordamage. The additional usable workspace exposed by the separation of theCC from the AO, described below, may be used by the clinician for theirsupplies and tools, solving the issue of “limited workspace” on smallermachines. Subliminally, this also allows the anesthesiologist toestablish “their space” in what can be a very crowded OR environmentcontaining many people and varieties of equipment. This space allowsthem to separate their clinical responsibilities and workflow from thosethat are more documentation and office related.

FIG. 2A illustrates an angular articulation of the breathing circuitconnection area 206 away from the AO 204. The breathing circuitconnection area 206 is both telescoped and rotated outwards, and a“cockpit” area is generated for the clinician, with the AO 204 on theright hand side and the CC 202 sweeping to the left. In thisconfiguration, the AO 204 can advantageously be positioned well awayfrom the patient and out of the clinical field, but the CC 202, with allthe clinical controls can be positioned in close proximity to thepatient. It is observed that the additional angular rotation of thebreathing circuit area 206 also exposes additional workspace 212 for theclinician.

In various embodiments of the present invention, the telescopic motionand angular rotation movements of the anesthesia system and itscomponents can be deployed in a variety of configurations allowing theCC 202 to be positioned at a plurality of locations relative to the AO204. As mentioned above with respect to FIG. 1A, three types ofmovements are available to position the CC 202 relative to the AO 204 inthe anesthesia system of the present invention.

In one embodiment, a rotational movement can be used to rotate CC 202away from or towards AO 204 at junction 295, in incremental angles.FIGS. 2A and 2B depict the anesthesia system of the present invention invarious configurations. FIG. 2A begins with the anesthesia system 200 ofthe present invention in a fully extended and rotationally openposition, with the rotational angle 275 in a fully open position of 45degrees. Angle 275 is rotated from a maximum of 45 degrees to a minimumof zero degree, in increments, until the CC portion 202 of theanesthesia system 200 is in a rotationally closed or collapsed positionand is thus rotationally flush with the system, with angle 275 at zerodegrees, as shown in FIG. 2B. In one embodiment, the rotationalincrements are indexed at preset angles, such as at every 5 degrees, orcontrolled continuously using a friction bearing to be any selectedangle. In a preferred embodiment, there is a detent at the zero degreeangle (that is, closed or collapsed position of system 200) so that whenthe system 200 is rotated fully closed it “clicks” shut in a positivemanner.

In another embodiment, a translational movement at junction 296 isavailable to telescopically or linearly compress and collapse the CC 202back into AO 204 or extend CC 202 away from AO 204. FIGS. 2C and 2Ddepict the range of translational movement of the system 200 at junction296 as the CC 202 is compressed and collapsed back into the AO 204. Inone embodiment, the translational movement range available to compressand collapse CC 202 back into the AO 204 is 14.5 inches. It should benoted herein that a translational movement at point 296 also results ina translational movement 298 at junction 297.

It should be appreciated by those of ordinary skill in the art that therotational and translational movements can be combined to have aplurality of positions of the CC 202 relative to the AO 204. Thus, inone embodiment, a workspace 299 can be accessed by either rotating ortranslating CC 202 away from AO 204 at junction 297, as shown in FIGS.2E and 2F. FIG. 2E depicts the angular motion of the CC 202 as it ismoved in at least one increment, away from AO 204, at an angle of, forexample, 5 degrees. FIG. 2F depicts the angular motion of the CC 202 asit is fully rotated away from AO 204 at an angle of 45 degrees, inaccordance with one embodiment, but when the anesthesia system 200 hasnot been expanded or telescoped for extra workspace. In addition, the CCmay be telescoped out from the AO (translational motion), creating orexposing additional workspace, as described above.

Hence, in various embodiments the CC of the anesthesia system of thepresent invention may be unilaterally moved towards a patient and awayfrom the main trolley apparatus containing the AO, cylinders andpipeline gas connections. Since, the CC carries all clinical controlsand visual displays necessary for the clinician's direct treatment ofthe patient, these areas remain within easy reach and sight of theclinician addressing the patient. The resulting system architectureeliminates the need for external connections to the CC and requires only“clean” pneumatic pipeline and power supplies to be provided. In oneembodiment, the CC itself could be utilized as a small anesthesiasystem, utilizing a longer umbilical to electrical and pneumaticsources.

FIG. 3A is an illustration of a clinician 310 standing near theanesthesia system 300 of the present invention. Thus, in thisillustration, one can see the relative dimensions of the system withrespect to the clinician 310. FIG. 3B illustrates the clinician 310using an expandable pull-out shelf 305 located on system. FIG. 3Cillustrates the clinician 310 sitting at the AO portion 304 of thesystem 300, when it is in a fully collapsed configuration.

FIG. 4A illustrates the side storage 402 provided in the AO 404 inaccordance with an embodiment of the invention. The side storage 402 maybe used by a clinician to store odd shaped and longer items that wouldnot typically fit well in storage drawers. FIG. 4B is an illustration ofthe side storage door 403 in an open configuration. FIG. 4C is anillustration of the side storage door 403 in a closed configuration.

FIG. 5A illustrates pull-out shelves in the AO in accordance with anembodiment of the invention. Pull/slide-out shelves/trays 504 and 506are provided at different heights and can be used for a plurality ofpurposes such as for placing a computer keyboard. Further, also shown inFIG. 5A is at least one moveable monitor screen or display 507.

FIG. 5B illustrates lower pull-out shelf 506, when it is pulled out ofthe AO of the system, further showing a keyboard on the pull-out shelfFIG. 5C shows the lower pull-out shelf 506 in a hidden configuration,when it is stowed into the AO of the system.

FIG. 5D illustrates upper pull-out shelf 504, when it is pulled out ofthe AO of the system. In one embodiment, upper pull-out shelf can beused as a writing desk for the clinician to take notes while he or sheis standing. FIG. 5E shows upper pull-out shelf 504 in a stowed orhidden configuration.

FIG. 6A illustrates space provided for storage and for electricalconnections in the AO in accordance with an embodiment of the invention.In one embodiment, storage cubbies 608 and 610 may be used for storageof office items like pens, notes, clipboards, files, etc. The electricalconnectors 612 and 614 may be used by clinicians for connecting theirpersonal electronic devices. FIG. 6B is a further illustration ofstorage cubby 608. FIG. 6C is an illustration of one embodiment of anelectrical connection area 615, which may include three-prong outlet616, Ethernet port 617, and at least one USB port 618.

FIG. 7A illustrates a handle activated castor lock provided in the AO inaccordance with an embodiment of the invention. The handle-based lock702 allows quick and small adjustments of the position of the anesthesiasystem. FIG. 7B is a further illustration of handle-based lock 702.

FIG. 8 illustrates a medical tape dispenser 805 provided on the CC 802in accordance with an embodiment of the invention. FIG. 8 also shows thephysiological monitor (shown as 132 in FIG. 1C) parameter connections832.

As shown in FIG. 9A, in one embodiment, the AO 904 includes a SystemStatus Computer (SSC) 905 for conveying information to the userconcerning the status of the anesthesia system's pneumatic, electrical,SW and communication functions. The SSC 905 collects all informationrelated to the technical status of the anesthesia system into one smalldisplay unit.

This provides the user with an intuitive separation of the anesthesiasystem's operation and functional information, from the clinicalinformation associated with the therapy that the system is providing.The SSC 905 off-loads functions from a main clinical display unit (notshown) and provides an intuitive separation of technical measurementsfrom those used directly for clinical care.

In various embodiments the SSC 905 provides information such as:pipeline pneumatic pressures, cylinder pressures, AC electrical powerstatus, DC electrical power status, backup up electrical power (e.g.battery) status, software version, internal CPU serial numbers andrevisions, system time and date, timer and alarm status, unit operationhours, last checkout and status, etc. This information can be conveyedeither in a numeric format or graphically via fill bars, or emulation ofpressure gauges.

In one embodiment, the SSC 905 remains powered on, available to presentits information, even when the anesthesia system is turned off ordisconnected from mains supplies. In this manner, the SSC 905 remainscontinuously ready to provide all data, but specifically cylinderpressure and pipeline pressure information to the user withoutactivating the main portion of the anesthesia system. The SSC 905 mayoperate in a sleep/dormant mode when the power of the anesthesia systemis turned off in order to conserve power and its display is turned on bya single user touch. The SSC 905 is capable of operating on batterypower, allowing observation of system status even if the system is notconnected to AC mains. Prior art systems utilize a mix of mechanicalgauges and measurements displayed on a clinical display unit in order toconvey system status information to the user. In an embodiment, byutilizing flat liquid crystal display (LCD) technology, the SSC 905 canbe placed under a transparent surface of the AO, such as a flatwork-surface. The collection of all relevant system information in anelectronic format obviates the need for mechanical gauges that consumesignificant space on the usable face of the anesthesia system. In theAO, the space normally used for mechanical gauges in conventionalsystems, is freed up and is better utilized for storage or other officetype functions. FIG. 9B provides an illustration of SSC 905.

Information Projection Lighting

In one embodiment of the present invention, direct lighting of an areaof the system in association with an alarm, for example, any area of theanesthesia system being suspected of undergoing a technical problem, isprovided, in order to unambiguously and intuitively guide the user'sattention to the likely source of the problem reflected by the alarm.Thus, the information projection lighting of the present inventionindicates an anomalous operational condition by illuminating the portionof the anesthesia system causing or likely to cause the anomalous/alarmcondition.

For example, in an anesthesia system, a case of “sticking” non-returnvalves (check valves) may manifest as an inability to ventilate apatient. Even though an alarm message indicating a low ventilationcondition may be generated, the direct lighting feature of the presentinvention causes a red flashing light to emanate from the check valvearea, thereby guiding the user's attention to the potential source ofthe problem. In one embodiment, this lighting may be very dispersive innature causing the whole check valve dome to light with red or othercolors. If more than one function of the system could be the cause forthe alarm, multiple areas may lighted or a user may be guided to stepthrough them in a sequence, presumably most likely to least likely.

In one embodiment, information projection lighting is used foridentification of proper attachments and work zones. For example, manyknown anesthesia systems use a “Common Gas Outlet” (CGO) for inductionpurposes. This requires a user to select CGO as the source of common gasusing the anesthesia system's controls. To eliminate a potential errorof having a patient attached to the CGO without it being selected as thesource of the common gas, information projection lighting is used toilluminate the concerned port and attached translucent tube. In oneembodiment, as shown in FIG. 9B, if the CGO is not selected, the port910 is illuminated in a first color, such as amber; if the CGO isselected via rotating the port body to a horizontal position, the portlighting is illuminated in a second color, such as green, while theports of the circle system 915 are simultaneously illuminated in a thirdcolor, such as red, indicating that they are not in use.

Referring now to FIGS. 10A and 10B, a switch 1002 is provided as a twoposition lever for a moveable CGO that is activated when the port isrotated up to a horizontal position. As shown in FIG. 10A, in a firstposition, switch 1002 is in a horizontal position and activates the CGOport. The first position is preferably parallel to a work surface 1004of the system. As shown in FIG. 10B, in a second position, switch 1002is preferably in a vertical position, and orthogonal to a work surface1004 of the system and deactivates the movable CGO.

A similar use of the information projection lighting may be made in thebag to vent area. In an embodiment, when “vent” operation is selected,the bellows itself could be lit in any color, such as green. FIGS. 10Aand 10B show the bellows 1006 lit when ventilation is active. Similarly,the APL valve and circuit pressure gauge are illuminated with adifferent light color, such as amber, when the ventilator of theanesthesia system is in an inactive off state.

In one embodiment, information projection lighting is used to indicatestatus (such as, on/off or engage/disengage or active/inactive) of theplurality of controls by direct illumination of the controlled function.By way of example, with reference to FIG. 1A, the arm of bag 153 isilluminated to indicate ventilator inactive/active or off/on state; theCO₂ absorbent canister 155 is illuminated if the canister 155 isdisengaged from the breathing circuit and/or if there is an alarm forhigh CO₂ in the respiratory gas; again, the side stream respiratory gasmonitor water trap is illuminated if the respiratory gas monitor (housedwithin physiological monitor 132 of FIG. 1C) is alarming for anobstruction. In various embodiments the information projection lightingmay be used for indicating vaporization on/off, circle system portsenabled/disabled depending upon whether the ventilator is inactive/inactive state, suction on/off, auxiliary oxygen on/off, carbondioxide bypass on/off, etc.

Persons of ordinary skill in the art should appreciate that theinformation projection lighting, of the present invention, is adjustablefor color, intensity and/or flashing rate in accordance with a user'sneeds/preferences.

Hence, the present invention provides a system and method for theidentification of problem areas in an anesthesia system in anunambiguous and intuitive manner through the use of subtle lighting ofsuspected problem areas in association with these alarms. With thepresent invention, the user will be immediately directed to the area ofthe system in need of examination or correction and will not incurunnecessary distraction or defocus from patient care. Further, thevisual lighting of the affected system area will enable other personnelin the OR to assist in the diagnosis or recognition of the problem.Through information projection visual lighting, operational elements ofthe system whose function may be engaged or disengaged are clearlyidentified, decreasing the potential for clinical errors.

Enhanced Flow Tube Visualization

In conventional anesthesia delivery and ventilation systems, flow tubesare commonly used to serve as a simple, clear, and reliable mechanicalmethod to ensure proper operation of a device—often in the event of anelectronic failure or as a cross check of the electronic flow readings.As shown in FIG. 9B, the present invention optionally includes animproved visualization method for a flow tube 916 used as a backup toelectronic fresh gas flow measurement. An exemplary flow tube isdescribed in U.S. patent application Ser. No. 12/775,719, filed on May7, 2010 and assigned to the assignee of the present invention, and isherein incorporated by reference in its entirety.

Wireless Proximal Sensor(s)

In an embodiment, the present invention provides a single, small sensorsolution for proximal placement without tubes or connections back to theanesthesia system. Using small sensors positioned directly at the airwayprovides optimal flow and pressure measurement signals. The integraldocking station for the wireless sensor not only provides power rechargeand signal connection, but also provides a physical storage location forthe sensor between cases or when it is not in use. In an embodiment, theanesthesia system of the present invention provides an autoclavable flowsensor with a wireless chipset, including CPU power to perform wirelessfunction, sensor sampling and processing.

In an embodiment, the wireless proximal sensor provides reliablecommunications in an Operating Room Environment up to a distance of 30feet. In various embodiments, wireless technologies such as 802.15.4(low-level IEEE spec for Zigbee), SynkroRF (developed by Freescale),RF4CE (Industry Consortium), ANT and/or ANT+, Bluetooth, Low PowerBluetooth, etc. may be employed. In various embodiments the wirelessproximal sensor fits within a battery based power budget and its designis tolerant to high humidity environments.

In one embodiment, an airway pressure sensor having the followingcharacteristics is employed:

-   -   Dynamic range: −20 to 120 cmH₂O    -   Resolution: 0.01 cmH₂O (calculates to about 14-bit resolution)    -   Bandwidth: 60 Hz (Guidance for on board analog and digital        filtering)    -   Output (decimated) sample rate: 250 Hz (4 msec period)        In one embodiment, a differential pressure sensor is employed        having the following characteristics:    -   Dynamic range: ±2.5 cmH₂O    -   Resolution: 0.0004 cmH₂O (Calculates to about 14-bit resolution)    -   Bandwidth: 60 Hz (Guidance for on board analog and digital        filtering)    -   Output (decimated) sample rate: 250 Hz (4 msec period)

The use of a wireless sensor requires detection of loss of proper signalsuch as a data dropout for more than 12 to 50 msec, thereby causing thesystem's internal sensors to be used. Additionally, wireless batterymonitoring predicts loss of signal, and a seamless use of backup sensorsystems. The anesthesia system of the present invention is provided withthis backup means via Fresh Gas Flow sensors and Drive Gas Flow sensor.These sensors form a redundant network of flow information to be usedfor error checking the proximal sensor and continuity of ventilationdelivery if the wireless proximal sensor becomes disabled.

In an embodiment, as shown in FIG. 9C, an integral “docking” station 920for the wireless proximal sensors 921 is provided on the anesthesiasystem that provides a coded data communication channel as well as powerfor recharging the wireless sensor batteries. The wireless proximalsensor establishes a communication link to the anesthesia system onlywhile physically sitting in the docking station. A user is required toremove the sensor from the docking station 920 and place it at theproximal airway. In an embodiment, the use of lighting as describedabove in the “Information Projection Lighting” section providesinformation that the sensor channel is active.

In one embodiment, the wireless sensor is separated into two parts, awireless communication pod and a sensor pod that is coupled to thewireless communication pod. Only the wireless communication pod, whichprovides communication to the anesthesia system, is placed into thedocking station. For example, the wireless communication “pod” could beattached to a “pitot” type flow sensor, in one embodiment.

Circle-Less Breathing Circuit

In one optional embodiment, the anesthesia system of the presentinvention provides a circle-less breathing circuit for patients. Mostcurrent anesthesia systems employ a ‘circle circuit’ that contains a CO₂absorbent for recycling some amount of breathing gas which is thenconveyed back to the patient. Conventional anesthesia systems alsotypically employ ‘mixers’ that combine oxygen, air and nitrogen gasesprior to introduction into the circle circuit as ‘fresh gas’.

FIG. 11A illustrates some basic elements of a conventional circlebreathing circuit indicating which major elements have been eliminated,or are not required, in the circle-less breathing circuit of the presentinvention. Absorber element 1102 and bellows 1104 have been eliminatedin the circle-less breathing circuit provided by the present invention.Further, check valves used in the circuit illustrated in FIG. 11A arealso replaced with active valves such as those used in typical, flowvalve controlled ICU ventilators.

FIG. 11B illustrates a circle-less breathing circuit 1100, in accordancewith an embodiment of the present invention. As shown, fresh gas isinjected through an inspiratory valve 1108, mixed with an injected agent1112, delivered to a patient 1110 and then led out via an expiratoryvalve 1114. In an embodiment, the fresh gas can be oxygen or air, thusrequiring only a single control valve for inspiration. In anotherembodiment, the inspiratory valve 1108 comprises multiple control valvesdesigned to blend oxygen, air and nitrous oxide directly into thecircuit. In an embodiment, the source of the fresh gas may be a highpressure pipeline or cylinder supply and the function of the inspiratoryvalve 1108 may be accomplished with proportional solenoid valves such asthose used on conventional ICU ventilators. Alternatively, a lowpressure fresh gas source such as room air or oxygen concentrator may beemployed and the inspiratory valve 1108 function may be accomplished byemploying a turbine or piston device to generate the necessary patientcircuit pressures.

In one embodiment the injected agent device 1112 utilizes gaseousanesthetic agent and is designed to control the injection of the agentto just the portions of the gas being delivered to the patient's lungs,since the circle-less circuit does not cause the gas provided throughthe inspiratory valve to be re-breathed. In an alternate embodiment, theagent is metered as a liquid and is vaporized into the gas streamutilizing a wick arrangement within the inspiratory portion of thebreathing circuit tubing 1106.

Using the circle-less breathing circuit 1100, a pulse train ofanesthetic gas may be injected in real-time into the inspiratory flowstream of a patient. The goal is to “phase” the pulse train of agent sothat a required portion of the pulse lands in the patient's lung and thedead-space receives no agent. In accordance with an embodiment of thepresent invention, an optional technique to minimize agent usage is toshape the anesthetic gas pulse so that dead-space receives no agent.Typically, dead-space comprises about 20% of the tidal volume. At theend of inspiration, the dead-space is filled with fresh gas; “phasing”the pulse train of the agent can help ensure that this trailing gascontains no anesthetic agent.

Also, since the patient is lying down, most of the posterior portion ofthe lung is perfused while the anterior portion is relatively lessperfused. Hence, an optimal shape of the pulse 1121 is square with sometaper towards the end, as illustrated in FIG. 11C. In an embodiment, agas monitor is employed to help with the dead-space and pulse phasing.Thus, the VCO₂ (volume of patient-generated carbon dioxide) and EtCO₂(end-tidal carbon dioxide) can be used to determine the dead-space whichis about equal to the volume of the endotracheal tube (ETT).

The agent injection is then linked to the delivery of an inspirationbreath and the end of agent delivery is phased to the inspiratory gasvolume that is projected to enter the dead space.

Hence, the anesthesia system of the present invention provides acircle-less breathing system at a lower cost than conventional circularbreathing circuits as a plurality of elements of conventional circuitsuch as bellows, absorber, replaceable absorber canister, mixer andconventional vaporizer, etc. have been eliminated. Further, by using thepresent circle-less breathing circuit 1100, soda lime (or substitutes)are removed from the environmental waste streams, and drive gas (orother form of energy) is not necessarily required, thereby making theuse of an oscillating pump for air and an oxygen concentrator as lesspower is required to run the circuit. Since, in the present circuit, theinspired gas is always clean, the circuit is optimal as far as infectioncontrol is concerned and is also easier to maintain, resulting in alower cost of ownership. Further, it has been observed that cliniciansare frequently confused regarding the dilution effects of the circlecircuit, thereby resorting to Inspired Gas Control (IGC) or Expired GasControl (EGC) systems. The present circle-less breathing circuit 1100provides IGC automatically, since there is no dilution effect. In anembodiment, the inspiratory valve feature may be implemented entirely insoftware and flows much higher than a traditional mixer may be achieved.

Electronic Vaporization

Contemporary anesthetic vaporizer systems contain valves and/or wicksystems for transitioning liquid anesthetic agent into a gaseous form.Typically, these systems provide an agent concentration level of 0-10%(although sometimes higher for Suprane) of the gas being used as “freshgas” or “make-up” gas in a circle breathing system. Contemporary devicesare rather complex and require precision mechanical components or flowcontrol systems to operate, creating a relatively high cost device. Anew type of vaporizer element has been described in U.S. Pat. No.6,155,255 that utilizes direct liquid injection into a low cost “wick”arrangement. This device is extremely simple, but would need to beintegrated into a system where the flow by the wick is known in order tobe practical. Further, the design of the liquid injection system wouldbe critical for proper functioning and would not be optimized by use ofa standard syringe pump as described in U.S. Pat. No. 6,155,255.

The present invention provides a method by which vaporizer elements,such as the one described in U.S. Pat. No. 6,155,255, may be integratedinto an anesthesia system, for practical use as an electronic vaporizer.In an embodiment, a micro-piezo pump is used for pumping the liquid tobe vaporized. Injection of the liquid is measured in a supply linesupplying liquid to the vaporizer, and control is accomplished using afeedback loop. Measurement of liquid flow into the evaporator (i.e.wick) and measurement of gas flow either into or out of the evaporator(difference being anesthetic vapor) is used in order to determineconcentration of anesthetic agent. This step is performed alternative toor in conjunction with anesthetic agent concentration measurement at thepatient site. Further, pulsing (i.e. increasing or decreasing) of liquidflow in conjunction with gas flow changes through the evaporator may beperformed. The evaporator is placed in the main flow stream of acircle-less breathing circuit anesthesia system, such as the onedescribed in the preceding section. A control unit controlling theliquid flow into the evaporator is connected to the display of ananesthesia system, integrating the vaporizer subsystem as a component ofa broader anesthesia system of the present invention. This allows agentdata to be presented with fresh gas flow rates and patient tidalvolumes.

In one embodiment a valve is added to a known electronic vaporizer, suchas the one described in U.S. Pat. No. 6,155,255, and is controlled toprovide for an immediate gas flow bypass of the evaporator. This is usedfor an oxygen flush of the system or for immediately turning off of thevaporizer. Proportional control of this bypass may also be used toquickly reduce the amount of vapor being added without entirely ceasingthe vapor addition, as is the case with a complete bypass. Further, acomponent of the fresh gas flow (e.g. Oxygen) may be selectively passedthrough the evaporator in order to obtain a consistent uptake ofanesthetic agent vapor. In an embodiment, a liquid type agent detectionmeans is added to either a pump connected to an external container ofthe liquid anesthetic (from which the liquid anesthetic is pumped intothe vaporizer) or the container itself for determining the anesthetictype. Further the container may comprise a plurality of reservoirs, theoperation of each controlled by a pump controller unit, thereby allowingfor multiple anesthetic agent types to be present on a single anesthesiamachine. The reservoir(s) containing the anesthetic agents may be cooledto maintain anesthetic agents in liquid form for injection by the liquidinjection means of a pump—connected to pump the agents into thevaporizer. In various embodiments various protection means and means forelimination of liquid cavitation are employed. Examples of such meanscomprise cooling of one or more pumps to prevent cavitation as theanesthetic liquid is pumped through, pressurizing of anesthetic agentreservoirs into a connected pump to prevent cavitation, employingcavitation detection means in the pump or a supply line connecting thereservoirs to the pump, employing specific known design features in thesupply line or pump to prevent cavitation, and adding resistance to thesupply line thereby creating backpressure in order to preventcavitation.

The method of the present invention allows for selection of differentevaporator sizes based on the amount of fresh gas flow. For example, ananesthesia control means (such as a knob or switch) could select eithera high flow or a low flow evaporator depending on the amount of freshgas flow being used. Also, an On/Off valve may be employed in theanesthetic agent supply line as a safety control to immediately stopliquid injection into the evaporator. In an embodiment, a sensor elementis positioned at the patient airway for reading the optical absorptionof the gas being inspired by the patient at different light wavelengths,and the signals sensed at that point are used for performing eitherinspired gas control or expired gas control using the vaporizer as asubsystem of an anesthesia machine. Further, in an embodiment, twoliquid flow sensors are used in series, one high flow and one for lowerflow, in order to sense the full range of liquid flow rates atsufficient accuracy.

The above examples are merely illustrative of the many applications ofthe system of present invention. Although only a few embodiments of thepresent invention have been described herein, it should be understoodthat the present invention might be embodied in many other specificforms without departing from the spirit or scope of the invention.Therefore, the present examples and embodiments are to be considered asillustrative and not restrictive, and the invention may be modifiedwithin the scope of the appended claims.

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 20. Ananesthesia delivery system, comprising: a first section comprisingsupport for at least one clinical control and at least one patientconnection for providing therapy to a patient, wherein said at least onepatient connection includes a breathing circuit connection, comprisingat least one limb, wherein the at least one limb may be inspiratory,expiratory or a combination thereof; a second section, comprising a baseportion for supporting and housing the first section and at least onepneumatic or electrical connection, wherein the first section islinearly, rotatably or linearly and rotatably extendable relative to thesecond section, and wherein the second section is pneumaticallyconnected to the first section via a suction supply line or ananesthesia gas supply line; and a lighting system for indicating thestatus of at least one function of the system by direct illumination.21. The anesthesia delivery system of claim 20 further comprisingadjustable lighting, wherein the lighting can be adjusted by color,intensity or flash rate.
 22. The anesthesia delivery system of claim 20wherein the lighting system indicates an anomalous operational conditionof the anesthesia system by direct illumination of the portion of theanesthesia delivery apparatus suspected of causing the anomalousoperating condition.
 23. The anesthesia delivery system of claim 20wherein the lighting system indicates when a ventilator within theanesthesia system is in an active state by illuminating a bellows of theventilator.
 24. The anesthesia delivery system of claim 20 wherein thelighting system indicates when a ventilator within the anesthesia systemis in an inactive state by illuminating an APL valve of the ventilator.25. The anesthesia delivery system of claim 20 wherein the lightingsystem indicates when a ventilator within the anesthesia system is in aninactive state by illuminating a pressure gauge of the ventilator. 26.The anesthesia delivery system of claim 20 wherein the lighting systemindicates when a ventilator within the anesthesia system is in aninactive state by illuminating a bag arm of the ventilator.
 27. Theanesthesia delivery system of claim 20 wherein the informationprojection lighting system illuminates a common gas outlet port of theanesthesia system when controls are set to have gas emerge from thecommon gas outlet port.
 28. The anesthesia delivery system of claim 20wherein the lighting system illuminates an auxiliary flow tube ifauxiliary flow has been turned on.
 29. The anesthesia delivery system ofclaim 20 wherein the information projection lighting system illuminatesa CO₂ absorbent canister indicating a CO₂ level status, such as when thecanister is not present in the breathing circuit and/or if there is analarm for high CO₂ levels in the respiratory gas.
 30. The anesthesiadelivery system of claim 20 wherein the lighting system illuminates aside stream respiratory gas monitor water trap if the respiratory gasmonitor is alarming to indicate an obstruction.
 31. A lighting systemfor indicating an operational status of at least one predefined portionof an anesthesia system wherein: said at least one predefined portion ofsaid anesthesia system is illuminated based upon operational status ofsaid at least one predefined portion; said operational status comprisesat least one of on/off, active/inactive, or anomalous operation statesof said at least one predefined portion; and, said anesthesia systemdelivers a predetermined continuous supply of one or more medical gasesmixed with a predetermined concentration of an anesthetic vapor to apatient and monitors at least a pressure and a flow rate of saiddelivered medical gasses.
 32. The lighting system for indicating anoperational status of at least one predefined portion of an anesthesiasystem of claim 31, wherein said predefined portion comprises at leastone of a bellows, an adjustable pressure-limiting (APL) valve, apressure gauge, an auxiliary flow control port, or a bag arm.
 33. Thelighting system for indicating an operational status of at least onepredefined portion of an anesthesia system of claim 31, wherein saidlighting system illuminates a common gas outlet port (CGO) of saidanesthesia system when one or more controls are set to allow at leastone gas to emerge from said CGO port.
 34. The lighting system forindicating an operational status of at least one predefined portion ofan anesthesia system of claim 33, wherein said lighting systemilluminates a common gas outlet port (CGO) of the anesthesia system in afirst color if said CGO port is not selected and is in a first vertical,downward facing position, and in a second color when said CGO port isselected via rotating a body of said CGO port from said first vertical,downward facing position to a second horizontal, forward facingposition.
 35. The lighting system for indicating an operational statusof at least one predefined portion of an anesthesia system of claim 31,wherein the lighting system illuminates an inspiratory and an expiratoryport of the anesthesia system when one or more controls are set toinhibit gas from emerging from a common gas outlet (CGO) port of saidanesthesia system.
 36. The lighting system for indicating an operationalstatus of at least one predefined portion of an anesthesia system ofclaim 31, wherein said lighting system illuminates a carbon dioxideabsorbent canister of said anesthesia system canister indicating a CO₂level status, such as when the canister is not present in a breathingcircuit of said anesthesia system and/or the level of carbon dioxide gasindicated in a respiratory gas monitor of said anesthesia system risesabove a predetermined level.
 37. The lighting system for indicating anoperational status of at least one predefined portion of an anesthesiasystem of claim 31, wherein said lighting system illuminates a sidestream respiratory gas monitor water trap control of said anesthesiasystem when there is an obstruction in said side stream respiratory gasmonitor water trap control.
 38. The lighting system for indicating anoperational status of at least one predefined portion of an anesthesiasystem of claim 31, wherein said lighting system illuminates multipleportions of said anesthesia system when more than one portion issuspected of causing an anomalous operational state, said illuminationvarying in at least one of color, flashing rate, or intensity, in aparticular pattern, for guiding a user to inspect the illuminatedportions in a particular sequence.
 39. The lighting system forindicating an operational status of at least one predefined portion ofan anesthesia system of claim 31, wherein said illumination comprisesspecific characteristics, further wherein said characteristics compriseany one or more of color, flashing rate, and intensity.
 40. The lightingsystem for indicating an operational status of at least one predefinedportion of an anesthesia system of claim 39, wherein saidcharacteristics are user adjustable.